Case Study of a Diabetic Patient

This case study discusses the medication, physical challenges, and emotional issues faced by a diabetic patient named Ben. It covers topics such as the components of a valid insulin medication order, the onset of action of insulin Novo rapid, appropriate needle length and angle, and documentation required. It also discusses the physical and emotional challenges faced by the patient and the importance of understanding medication before administering it to the patient.

Running Head: DIABETIC PATIENT
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Student Details
[COMPANY NAME]
Case Study of a
Diabetic Patient
[Document subtitle]

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Table of Contents
Part A....................................................................................................................................................1
Answer 1...........................................................................................................................................1
Answer 2...........................................................................................................................................1
Answer 3...........................................................................................................................................2
Answer 4...........................................................................................................................................2
Answer 5...........................................................................................................................................3
Answer 6...........................................................................................................................................3
Answer 7...........................................................................................................................................3
Answer 8...........................................................................................................................................4
Answer 9...........................................................................................................................................4
Answer 10.........................................................................................................................................4
Answer 11.........................................................................................................................................5
Part B.....................................................................................................................................................5
Answer 1...........................................................................................................................................5
Answer 2...........................................................................................................................................5
Reference...............................................................................................................................................6

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Part A
Answer 1
11 components of a valid insulin medication order
1. Patients uniform resource name, his or her family and given names, date of birth,
address, and sex
2. National inpatient medication chart (NIMC) is marked
3. First prescriber identity level checked
4. Details of the hospitals
5. Physician to notify
6. Signature and printed name of the medicine prescriber
7. Date
8. Dose
9. Name of the insulin (example: Novo rapid)
10. Meal or time
11. Physician’s initials (Berman et al., 2014).
Answer 2.
Diabetes type 1 happens when the body’s immune system of a patient starts
destroying the cells of the pancreas known as beta cells. These cells are insulin-producing
cells; this insulin hormone is used as a fuel by cells to move sugar, glucose into tissues of the
body. Damages to these cells impaired the process and the tissues do not get the above
mentioned essential elements (LeMone et al., 2017). Using insulin can lower the blood
glucose level by providing glucose or sugar uptake into the body cells; it prevents the
gluconeogenesis and glycogenolysis in the liver, and initiates glycogenesis. It also triggers

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the stimulations of amino acid uptake into the body cells via protein synthesis and promotes
storage of fat (Bullock & Manias, 2017).
Answer 3
The onset of actions of insulin Novo rapid is 0-0.25 Hours that means it starts
showing effects after 15 minutes of injecting. The peak effect of this medicine is 1 hours and
duration of action of is 3.5 to 5 hours. The Aspart insulin should be administered shortly
before or shortly after having a meal to control the glucose that increases after eating food.
Insulin should be injected no more than 5 to 10 minutes before having food (Bullock &
Manias, 2017).
Answer 4
Hypoglycemia is the health condition which is caused due to very fewer levels of
blood glucose level. It often causes during the treatment of diabetes. There are other
conditions that can also cause this health issues like fever. Symptoms of this health
conduction include hunger, irritability, pale skin, fatigue, mild tachycardia, pallor, sweating,
tremors, and restlessness. In severe cases seizures, coma and death might be caused.
Hypoglycemia can be caused by an imbalance between the carbohydrates or glucose, insulin,
and activity. The treatment of this insulin abnormality includes immediate glucose
replacement, quick acting carbohydrates by consuming fruit juice, sugar or honey, and
jellybeans. The slow acting carbohydrates can be used from a sandwich or the piece of fruit
(Craft et al., 2015). The side effects of NovoRapid insulin are the pain, hypos, and redness,
itching and swelling at the site of injection, bruising, and hive. According to a report
published in NPS medicineswise (2018), the worse adverse effects of this medication include
disorientation, convulsions or fits, seizures, and loss of consciousness.

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Answer 5
Understanding the medication before administering to the patient is very important.
For example, to reduce the medication errors that can occur after medication or at the time of
medication. For example, checking the name of the medicine and its level is necessary to
ensure that the right medicine is being provided to the patient. By understating the
medication the nurse can be sure that medicine will be used for the person is completely safe.
Asking the patient for any allergies related to that medication is also the part of
understanding the medication completely. And it helps the nurse to prevent any allergies or
adverse reaction after administration if the medication (Keers, Williams, Cooke & Ashcroft,
2013).
Answer 6
Following are the 5 rights of medication
I. Right medicine or drug
II. Right doses
III. Right patient
IV. Right route of administration
V. Right time
These five rights of medication are very important to prevent occurrence if any
medication errors and to ensure that right medicine is used for the right patient with right
doses at right time and via the right route of administration (Nazarko, 2015).
Answer 7
Right needle length: the right length of needle for Ben should be 4mm to 6mm length
because of the thin subcutaneous skin layer as he is a skinny person. This length will ensure

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that the medication is delivered to SC tissues and not IM (Australian Diabetes Educators
Association, 2015).
Answer 8
Diabetes-specific nursing assessment
 Asking the patient for any allergies related to the medicine or its content
 Checking the medicine name so that right medicine is administered to the patient
 Checking the expiry date of the medicine as it can cause other health issues to the
patient.
 Performing blood glucose level tests and checking ketone level so that the results can
be compared after insulin administration (Childers & Levesque, 2013)
Answer 9
Appropriate site: the lower abdominal site is the best site in Ben's case to inject the medicine.
To ensure the patient's comfort and effective delivery to subcutaneous tissues and for better
absorption of the medicine.
Appropriate angle: 90 degree is the best angle for Ben to make sure the SC delivery of insulin
(Bronger, 2014).
Infection control considerations
During the administration of insulin and testing blood, glucose levels blood Bourne
viruses like HBV, hepatitis B, and HIV can infect the person. Therefore the administration
should be done carefully. The contaminated devices should not be used to test or
administrating insulin. Using insulin pen and blood glucose meter that is already used for
another person can also cause infection (Centers for Diabetes Control and prevention, 2017)

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Answer 10
Documentation required in Ben's case should be reported on EMAR. The information
should be noted during medication should include the name of the patient, type of insulin
provided, the strength of doses, concentration of the medicine, length of needle that is used to
inject the drug, angle at the medicine is injected and any adverse reaction that occurs after
medication. This can help to prevent medication errors and to provide better care to the
patient (Tauschmann, & Hovorka, 2014).
Answer 11
Diabetes-specific nurses’ assessment should be done for ben after insulin
administration includes testing ketone and blood glucose levels, any allergies or adverse
effects after injecting the Aspart insulin (National Health Services, 2017).
Part B
Answer 1
Physical challenges Ben might face are fatigue, gastroparesis or delayed emptying
meal form the stomach, nausea, bloating. Heartburn and kidney damage in severe cases. Foot
and leg ulcers often caused in case of a diabetic patient due to the reduction in blood flow to
that specific part of the body (Freeborn, Dyches, Roper & Mandleco, 2013).
Answer 2
The patient used to play football regularly and feeling tired due to diabetic symptoms,
he may not be able to play the game like before, this feeling of detachment from the game
can affect the patient emotionally. Behavioural changes often occur in patient with this health
condition. Other emotional or mental issues that might be caused in Ben’s case are feeling
alone, stress and anxiety, the problem in remembering the medication (Schabert, Browne,
Mosely & Speight, 2013).

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Reference
Australian Diabetes Educators Association (2015). Clinical Guiding Principles for
Subcutaneous injection Technique. Retrieved from: https://www.adea.com.au/wp-
content/uploads/2015/11/Injection-Technique-Final-digital-version2.pdf
Berman, A., Snyder, S. J., Kozier, B., Erb, G. L., Levett-Jones, T., Dwyer, T., & Parker, B.
(2014). Kozier & Erb's Fundamentals of Nursing Australian Edition. (3rd ed.).
Melbourne, Australia: Pearson Higher Education AU.
Bronger, C. (2014). Specialty practice series: Insulin pen needles and adherence. AJP: The
Australian Journal of Pharmacy, 95(1128), 68.
Bullock, S., & Manias, E. (2017). Fundamental of pharmacology (8th ed.). Frenchs Forest,
NSW: Pearson Australia, p. 752.
Centers for Diabetes Control and prevention (2017). Infection prevention during blood
glucose monitoring and insulin administration. Retrieved from:
https://www.cdc.gov/injectionsafety/blood-glucose-monitoring.html
Childers, B., & Levesque, C. M. (2013). Use of insulin in the noncritically ill-hospitalized
patients with hyperglycemia and diabetes. Critical Care Nursing Clinics, 25(1), 55-
70.

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Craft, J., Gordon, C., Tiziani, A., Heuther, S., McCane, K., Brasher, V., & Rote, N. (2015).
Understanding pathophysiology. (2nd ed.). Chatswood, NSW: Elsevier Australia, p.
1049.
LeMone, P., Burke, K., Levett-Jones, T., Dwyer, T., Moxham, L., Reid-Searl, K., &
Raymond, D. (2015). Medical-surgical Nursing: Critical Thinking for Person-centred
Care. (3rd ed.). Frenchs Forest, NSW: Pearson Australia. Chapter 19.
Marieb, E. N., & Hoehn, K. (2016). Human Anatomy and Physiology (10th ed.). Essex, UK:
Pearson, p.643.

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